Patterns and predictors of adherence to follow-up health guidance invitations in a general health check-up program in Japan: A cohort study with an employer-sponsored insurer database.

Though 70% of eligible adults attended Japan's annual cardiovascular risk check-ups, only 35% of individuals with high cardiovascular risk adhered to health guidance invitations. Future policy reforms to improve adherence to this program should target younger individuals and those with mild stages of hypertension, diabetes, or dyslipidemia.